1. Field of the Invention
The present invention relates to a surgical stitching instrument providing a combined suture holder and needle in which the needle is adapted to pierce tissue to be stitched, pick up a suture from the holder after piercing the tissue, and to retract through the tissue while dragging the suture from the holder therethrough and more particularly to such an instrument which is manipulatable with one hand by a surgeon while freeing the other hand for tissue arranging, positioning or other ancillary functions particularly desirable in deep surgery. The needle is attached to and is an integral part of the instrument, thus allowing better contact of the needle and ease of manipulation through tissues even in blind stitching.
2. Description of the Prior Art
It is a well-known surgical practice to clamp a needle with its attached suture with a needle holder and to push the needle through tissues to be stitched until it exits at the opposite side of the tissue. The needle is then released and clamped again at its leading end and extracted through the tissue together with the attached suture. This procedure is satisfactory in many instances except in suturing deep structures, in the presence of bleeding or exudation, it is difficult to reapply the needle holder after the needle has pierced the tissue.
Another well-known method of suturing, especially in deep surgery, is with the use of a Boomerang needle holder. The suture is clamped with a specialized instrument manipulated by one hand, the instrument then being maneuvered to place the suture adjacent to the tissue. A needle having a hook adjacent to the point thereof is then manipulated with another specialized instrument held in the other hand to pierce the tissue and the clamping instrument maneuvered so that the hook snags the suture. The suture is then unclamped with the one hand and the needle is withdrawn along its insertion path with the other hand to draw the suture through the tissue. The instruments and needle are then put aside and the suture tied.
This procedure is disadvantageous for several reasons. Both hands are fully employed during the insertion of the suture since one hand is required to operate the needle manipulating instrument while the other hand is required to operate the suture clamping instrument. It has long been recognized that it would be highly advantageous for surgeons to have one hand free for other procedures during such stitching operations.
These conventional procedures are relatively slow since, in sequence, the suture must be clamped, the needle must be guided through the tissue, the suture clamping instrument and the needle manipulating instrument must be operated to engage the suture with the needle, and the instruments must be withdrawn without disengaging the suture so as to draw the suture through the tissue.
The needle grasping and the suture clamping instruments are both of specialized construction, require great dexterity for proper operation, and the needle manipulating instruments are frequently complicated in structure and mode of operation.
It has also long been recognized that it would be highly advantageous to provide a single instrument usable by one hand whereby simple opening and closing movements pass a suture through a tissue in deep surgery and dispose the suture for tying.